Menzies Research Institute, Private Bag 23, Hobart TAS 7001, Australia.
Nutrients. 2010 Sep;2(9):985-96. doi: 10.3390/nu2090985. Epub 2010 Sep 16.
Feedback of fracture risk based on bone mineral density (BMD) is an under-explored potential osteoporosis education intervention. We performed a randomised controlled trial of either an osteoporosis information leaflet or small group education (the Osteoporosis Prevention and Self-Management Course (OPSMC)), combined with individualised fracture risk feedback in premenopausal women over two years. Women with a mean T-score at spine and hip of <0 were informed they were at higher risk of fracture in later life and those with T-score ≥ 0 were informed they were not. Women receiving feedback of high fracture risk had a greater increase in femoral neck, but not lumbar spine, BMD compared to the low risk group (1.6% p.a. vs. 0.7% p.a., p = 0.0001). Participation in the OPSMC had no greater effect on BMD than receiving the leaflet. Femoral neck BMD change was associated with starting calcium supplements (1.3% p.a., 95% CI +0.49, +2.17) and self-reported physical activity change (0.7% p.a., 95% CI +0.22, +1.22). Mother's report of increasing their children's calcium intake was associated with receiving the OPSMC (OR 2.3, 95% CI 1.4, 3.8) and feedback of high fracture risk (OR 2.0, 95% CI 1.2, 3.3). Fracture risk feedback based on BMD could potentially make an important contribution to osteoporosis prevention but confirmation of long-term benefits and cost effectiveness is needed before implementation can be recommended.
基于骨密度（BMD）的骨折风险反馈是一种探索不足的潜在骨质疏松症教育干预措施。我们对绝经前妇女进行了一项为期两年的随机对照试验，比较了骨质疏松症信息传单与小组教育（骨质疏松症预防和自我管理课程（OPSMC）），以及结合个体骨折风险反馈的效果。对于脊柱和髋部 T 评分<0 的女性，我们告知其在以后的生活中骨折风险更高，而 T 评分≥0 的女性则告知其骨折风险较低。与低风险组相比，接受高骨折风险反馈的女性股骨颈、而非腰椎 BMD 增加更多（1.6%/年 vs. 0.7%/年，p=0.0001）。与接受传单相比，参加 OPSMC 对 BMD 没有更大的影响。股骨颈 BMD 的变化与开始补充钙（1.3%/年，95%CI+0.49，+2.17）和自我报告的体力活动变化（0.7%/年，95%CI+0.22，+1.22）相关。母亲报告增加孩子的钙摄入量与接受 OPSMC（OR 2.3，95%CI 1.4，3.8）和高骨折风险反馈（OR 2.0，95%CI 1.2，3.3）相关。基于 BMD 的骨折风险反馈可能对骨质疏松症预防做出重要贡献，但在推荐实施之前，需要确认其长期效益和成本效益。
